BUFFALO, N.Y. – Clinicians are advised to never group Hispanic Americans under one collective identity. But when it comes to HIV testing, the desire to communicate with health care providers in Spanish nearly transcends ethnicity.

New University at Buffalo research that investigated the language preferences of Hispanic Americans seeking HIV testing in New York found that the majority of Hispanic patients preferred to receive care in Spanish, even if they were fluent in English.

Patients who preferred English were more likely to have U.S. citizenship, live in temporary housing, or be 18 years old and younger.

The research, led by Adrian Juarez, PhD, assistant professor in the UB School of Nursing, highlights how language barriers can restrict access to testing, diagnosis and treatment. Understanding these factors can inform outreach strategies to promote HIV testing in Hispanic communities.

"No matter their nation of origin, how long they've lived in this country or their level of English fluency, Latinos were still reporting a Spanish preference," says Juarez. "Rather than concentrating on cultural differences, Latino-focused HIV interventions should consider language, age, citizenship and housing status."

Allison Squires, PhD, associate professor in the Rory Meyers College of Nursing at New York University, is an additional investigator.

The researchers used 2002-11 survey data collected from the New York State AIDS Institute Reporting System to gather more than 5,000 responses from a Hispanic-focused, community-based organization. The data included demographics, and HIV testing and care history.

Spanish was the preferred language across all demographics except for age, citizenship and housing status.

Participants with U.S. citizenship were nearly 20 percent more likely to have an English preference. And 57 percent of individuals that were 18 years old and younger reported an English preference. All other age groups overwhelmingly favored Spanish.

The researchers were surprised to discover that English was the preferred language for nearly 58 percent of participants who were homeless or living in temporary housing. The finding contradicts previous studies that associate English proficiency with stable housing opportunities.

"We could be seeing the protective elements of an arrival community made up of family and friends for newly arrived Hispanic immigrants," said Juarez.

Since unstable housing is linked to poorer outcomes for HIV, he adds, these findings warrant follow-up study.

While Hispanic Americans in larger cities are able to find health care centers that can provide services in Spanish, those in smaller towns and communities are more likely to come across language barriers. These hurdles, says Juarez, compound on other barriers to care, which range from transportation to the social stigma associated with HIV.

By understanding the language preferences of different segments of the Hispanic community, health care providers and researchers can better tailor HIV outreach and interventions.

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The study was published in the January-February print edition of the Journal of the Association of Nurses in AIDS Care.

Future research will expand the study to include more participants and work to capture the appropriate gender of patients.